Buckhead Spine Specialist LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

BUCKHEAD SPINE SPECIALIST LLC

Practice address

2690 Buford Hwy NE Ste 200
Atlanta, GA 30324-5453

Phone

(404) 869-6400

Fax

(470) 299-6558

NPI assigned

May 10, 2022

Last updated

Oct 31, 2023By the provider in NPPES

Organization subpart

Yes

Parent organization

GWINNETT SPINE SPECIALISTS LLCAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dafne Schenendorf

Title

Cfo

Phone

(678) 687-6805

Specialties & licenses 5

Addresses

Part of

Gwinnett Spine Specialists LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Gwinnett Spine Specialists LLC

  • General Practice Physician
  • Duluth, GA
  • NPI 1841736303
  NPPES parent name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1700522059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2690 BUFORD HWY NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245453",
            "telephone_number": "404-869-6400",
            "fax_number": "470-299-6558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 BUFORD HWY NE STE 200",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303245453",
            "telephone_number": "404-869-6400",
            "fax_number": "470-299-6558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCKHEAD SPINE SPECIALIST LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GWINNETT SPINE SPECIALISTS LLC",
        "enumeration_date": "2022-05-10",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "SCHENENDORF",
        "authorized_official_first_name": "DAFNE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "678-687-6805"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Buckhead Primary Care, LLC
• Buckhead Smile Center, P.C.
• Buckhead Smiles Cosmetic and Family Dentistry LLC
• Buckhead Speech Specialists, Inc.
• Buckhead Spine Clinic LTD. Co.
• Buckhead Sports Medicine and Spine Center (Midtown Sports Medicine)
• Buckhead Surgical Associates LLC
• Buckhead Surgical Services, L.P. (Buckhead Ambulatory Surgery Center)
• Buckhead Urogynecology
• Buckhead Vision Inc

• Physical Medicine & Rehabilitation Physician in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.